Organization Active NPI

Green Leaf Physical Therapy PC

  • Physical Therapy Clinic/Center
  • New York, NY
National Provider Identifier
1720812977
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
GREEN LEAF PHYSICAL THERAPY PC
Practice address
501 5TH Ave RM 1204
New York, NY 10017-7873
Phone
(646) 777-2078
Fax
(646) 777-2057
NPI assigned
Aug 29, 2024
Last updated
Aug 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Byeungguk Lim, DPTNPI 1902525256
Title
Owner
Phone
(646) 777-2078

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

501 5TH Ave RM 1204
New York, NY 10017-7873

Mailing address

501 5TH Ave RM 1204
New York, NY 10017-7873
Phone (646) 777-2078

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1720812977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 5TH AVE RM 1204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100177873",
            "telephone_number": "646-777-2078",
            "fax_number": "646-777-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 5TH AVE RM 1204",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100177873",
            "telephone_number": "646-777-2078",
            "fax_number": "646-777-2057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN LEAF PHYSICAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "BYEUNGGUK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-777-2078",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.